Important Transparency in Coverage Machine Readable File Information
On November 12, 2020, the Departments of Health and Human Services, Labor, and Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create machine readable files (MRFs) that contain in-network negotiated payment rates and historical allowed amounts and billed charges for out-of-network providers and make those files publicly available. A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for future processing without human intervention.
The machine-readable files follow the Centers for Medicare and Medicaid Services (CMS) defined layout and are in the CMS approved format.
The self-insured medical vendor creates and publishes the Machine-Readable Files for the benefit plans they administer and maintain
on behalf of the Waffle House System Employee Benefit Plan. To view the Machine-Readable Files, please visit:
Machine Readable Files (anthem.com)
Search: 58-0652840 (may need to wait about 20 seconds)
Your Rights and Protections Against Surprise Medical Bills
On July 1, 2021, the “Requirements Related to Surprise Billing; Part I,” interim final rule was issued to restrict surprise
billing for patients in job-based and individual health plans who get emergency care, non-emergency care from out-of-network
providers at in-network facilities, and air ambulance services from out-of-network providers.
Surprise Billing Model Notice